VANCOUVER — For soldiers going to war or aid workers sent to disaster areas, the stress of their exposure to trauma can trigger serious depression and suicidal ideation. But imagine if before they left, or even as they were there, they could take a drug that would prevent the onset of future mental illness?
That’s the scenario neuroscientist Rebecca Brachman described as she stood on the TED stage here Monday and told the audience she may have helped discover a drug that could make people more resilient under the most stressful circumstances.
In 2014, Brachman was studying emotional behaviors in mice when she accidentally stumbled upon what could be one of the biggest breakthroughs in mental health pharmacology. She had given some mice the drug ketamine, also known as the psychedelic special K, which has been tried in trials as an antidepressant for treatment-resistant severe depression. Because the drug was known to wear off in a few hours in the mice and funds were tight, she ended up using some of the same mice for another later study testing mice’s resilience under chronic stress conditions.
So this wasn’t a treatment. This was prevention.
If it works in humans, she envisions the drug she’s helping develop could be used to give to soldiers going to war or to aid workers sent to disaster zones to manage their emotions in the aftermath. She’s not trying to “to make super soldiers without empathy,” she said in an interview after her talk, but instead prevent the onset of future depression or anxiety all too common among those who experience and witness trauma.
The 34-year-old neuroscientist at Columbia University was among two dozen TED Fellows chosen to present at the annual conference this year. The Fellows program provides them a platform for their ideas and access to the larger TED network to grow them. The young neuroscientist said she was drawn to the field in college. Always interested in big ideas, idolizing people like Galileo and William Blake as a child, the field of neuroscience was still ripe for new breakthroughs.
Now she may stand at the precipice of what could be one of the biggest discoveries in mental health possibly since anti-depressants were developed in the 1950s.
Hours after her talk Monday, Brachman sat at a table in a quiet area of the convention center when a man approached her. “Your talk inspired me. I was really fascinated,” he told her. “I just wanted you to know that.” This happened throughout the day at the TED2017 conference as Brachman adopted mini-celebrity status after her talk. It was hard for her to navigate the halls without someone stopping her to commend her work.
For Brachman, the positive reception to her research was surprising, yet she realized it shouldn’t be, given the statistics. If 1 in 5 people have a diagnosable mental health condition in a given year, then it’s likely that most people in the room had direct experience with some kind of psychological disorder, either personally or in someone they knew. And given that the World Health Organization recently named depression the leading cause of disability globally, a scientist advancing preventive medicine would be treated with rock star status.
She said she hopes sharing her research not only drives interest, but also adds to the growing conversation around mental health stigma. It’s only when society takes it as seriously as physical health that real progress will be made, she said.
With diagnoses of cancer and most other physical diseases, there is hope because of the medical treatments available. But in mental health, current treatments mostly just suppress the symptoms and the how and why they work are still being studied. Brachman, like most Americans, said she’s seen firsthand the suffering of people in her life dealing with chronic depression or bipolar disorder and the hopelessness those illnesses induce.
“I think once we have treatments for diseases, or preventions for them, it really changes the conversation. Things are stigmatized in part when there’s nothing you can do about it. They’re also mythologized when there’s nothing you can do about it,” she said. “From my experience, it’s more common than not. I’ve shifted my perspective from some people have mental illnesses to almost everyone I’ve ever met has had some direct experience.”
Brachman’s drug, which she said she plans to begin testing on humans next year, would be designed to inoculate those at risk of developing severe symptoms due to a stressful job or experience, not for people genetically predisposed to mental illness. It’s not a vaccine in the truest sense of the world, but Brachman believes that if she can show it is possible to prevent, not just treat or mitigate, mental illness, then it could open the door for all kinds of new preventive medicine.
Though mental illness is just that, an illness, and deserves to be treated as such, Brachman also notes that stress resilience exists on a spectrum of severity depending on the individual and the circumstance, and there are lifestyle interventions that can often help manage symptoms. Like a patient with diabetes, their care is commonly paired with diet and exercise.
In her work with stressed out mice, exercise has been shown to be “almost as robust as the drugs” in managing their mental heath, she said.
However, she is not suggesting that people take their care entirely into their own hands if they are suffering from a serious mental illness. No one would tell a diabetic patient not to take their insulin, for instance. So while some are critical of over medication in America, the option to prevent depression when suicide is on the rise and mental health is hurting productivity, is worth pursuing in conjunction with other holistic approaches, Brachman said.
“How quickly we get any of these treatments will depend on how as a society we prioritize it,” she said. “If this is a problem that’s affecting that number of people … if other people can stand up and say this is important we have to do something, it gives urgency to that aspect of the conversation.”
This piece was originally published on ‘The Washington Post’ April 25, 2017.